Individual
SIMONE GILLINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
8495 CRATER LAKE HWY, MAIL STOP 10, WHITE CITY, OR 97503-3011
(541) 826-2111
Mailing address
3115 ALAMEDA ST APT 15, MEDFORD, OR 97504-9677
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LDD10153903
OR
Other
Enumeration date
08/08/2014
Last updated
08/08/2014
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